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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This amendment allows the Georgia Medicaid program to establish programs to contract with one or more Medicaid RACs for the purpose of identifying underpayments and overpayments and recouping overpayments under the State Plan and under any waiver of the State Plan with respect to all services. All Medicaid RACs must be paid on a contingent basis for collecting overpayments.
Summary: This Amendment addresses the requirements regarding Estate Recovery per Section 115 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) by encouraging dual eligible beneficiaries to fully utilize Medicare cost-sharing benefits available through the Medicare Savings Program.
Summary: This amendment revises the methodology for making supplemental payments to nursing facilities under the Quality Assurance Assessment Program (QAAP).
Summary: This amendment revises the aggregate amount allocated for payments from the Indigent Care Agreement disproportionate share hospital (DSH) pool and updates the individual hospital payment amounts distributed from this pool.
Summary: This amendment revises the methodology for making disproportionate share hospital (DSH) payments from the Small Hospitals and Outpatient Uncompensated Care DSH pools.
